A 17-year-old developed fever, cough and dyspnea. History revealed that he had recently undergone ankle reconstruction surgery. For recovery, he was spending time in his media room- exactly next to the indoor pool.
Shortly after, his parents, brother and grandmother developed mild symptoms. Even more bizarre was the fact that grandmother was only a frequent visitor. She was not a permanent member of the house.
Indoor swimming pools and their maintenance:
Indoor pool rooms have complex environments that need regular maintenance. If proper ventilation, dehumidification, and care are not taken, the contaminated air gets trapped in the surroundings.Dehumidifiers are systems that remove excess humidity and pollutants from indoor pool air. They replace the contaminated air. They control the quality of air and aren’t heavy on the pocket too. Without these, a condition called Hot tub lung(HTL) or Hypersensitivity pneumonitis can occur.
Eventually, a home visit identified that a mould was present in the house. This was due to excess humidity. A check of the respiratory system and water from the indoor pool led to the finding of a bacterium.
The bacteria in Hot tub lung disease causes inflammation in the lungs. This leads to respiratory symptoms, low oxygen in blood and crackles on chest auscultation.
The real culprit:
This was one of the rare cases of HTL disease. Sampling led to the identification of causative bacteria, Mycobacterium intracellulare. This was present in the patient’s lower respiratory system. On the other hand, others were clear. The agent identification was the first step. Hence, the treatment then got easier. However, the family members were only treated conservatively.
Eventually, the pool and the whole house went through a thorough clean up.
Finally, follow up was within 2 years. In Hot Tub Lung disease, there is a possibility of permanent damage. Fortunately, the tests were clear as damage can be permanent too.
